Changes in Hip Muscles After Above‐Knee Amputation
Changes in Hip Muscles After Above‐Knee Amputation
复制标题
膝上截肢术后髋部肌肉的变化
DOI：
10.1097/00003086-199510000-00030
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发表时间：
1995
影响因子：
4.2
通讯作者：
Henry J. de Jongh
中科院分区：
文献类型：
--
作者：
S. Jaegers;J. Arendzen;Henry J. de Jongh
为了解膝上截肢后髋部肌肉的变化，对12例膝上截肢患者的髋部和大腿部进行了三维重建。在所有患者中，截肢是在研究前至少两年完成的，并且是由于创伤或骨肉瘤而必须进行的。结果表明，在更高的截肢节段，曾经的双关节肌肉的几何形状发生了变化。截肢侧的断裂肌(40%~60%)和完整肌(0~30%)萎缩。截肢侧完整肌肉萎缩程度与残肢长度有关。为避免8例截肢患者出现外展肌挛缩，髂胫束未固定。在这8名患者中，有4名患者可见屈曲肌挛缩。如果肌束不固定，插入肌束的臀大肌的髋关节伸展扭矩会减少。结果，屈曲肌挛缩出现的风险增加，因为截肢不涉及最强的髋屈肌(髂腰肌肌)。只有准确地固定髋内收肌，尤其是在较高截肢水平时，才能避免外展痉挛。
To learn about the changes appearing in hip muscles after an above-knee amputation, 3-dimensional reconstructions of the hip and thigh region of 12 patients with above-knee amputations were made based on transverse magnetic resonance images. In all patients, the amputations were done at least 2 years before the study and were necessitated by trauma or osteosarcoma. The results show that, at higher amputation levels, the geometry of the once-biarticular muscles was changed. The cleaved muscles (40%--60%) and the intact muscles (0--30%) at the amputated side were atrophied. The amount of atrophy of the intact muscles at the amputated side was related to stump length. To avoid an abduction contracture in 8 patients with amputations, the iliotibial tract was not fixed. In 4 of these 8 patients, a flexion contracture was visible. If the tract was not fixed, the hip extension torque of the gluteus maximus, which inserts into the tract, decreased. As a result, the risk of appearance of a flexion contracture increased because the strongest hip flexor (iliopsoas muscle) was not involved in the amputation. Abduction contracture could be avoided only if the hip adductors were fixed accurately, especially at higher amputation levels.